1Mansel Nelson, ITEP

Environmental Tobacco Smoke

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First Leading Cause of Lung Cancer

Smoking is leading cause of lung cancer  Causes an estimated 160,000 deaths in the

U.S. every year (American Cancer Society, 2004) 

Rate among women is rising  Now exceeds breast cancer

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Third Leading Cause of Lung Cancer

Secondhand smoke is third leading cause of lung cancer

Estimated 3,000 lung cancer deaths every year 

About 1,000 never smoked; about 2,000 former smokers

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5A Personal Choice

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SmokingHarms nearly every bodily organCausing many diseases, degrades healthEstimated 438,000 deaths (nearly 1 of 5

deaths) each year in U.S.More than by all deaths from human

immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined

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Smoking (cont.)Cancer is second leading overall cause of

death Lung cancer is the first disease directly

linked to smokingRisk of dying from lung cancer

23x higher among men 13x higher among women

Smoking also causes cancers of bladder, oral cavity, pharynx, larynx (voice box), esophagus, cervix, kidney, lung, pancreas, and stomach, and acute myeloid leukemia

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Smoking (cont.)Smokers 2–4 times more likely to develop

coronary heart diseaseSmoking doubles a person’s risk for strokeSmokers more than 10x as likely than

nonsmokers to develop peripheral vascular disease

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Smoking (cont.)Causes tenfold increase in risk of dying

from chronic obstructive lung diseaseMany adverse reproductive and early

childhood effects, including increased risk for infertility, preterm delivery, stillbirth, low birth weight, and sudden infant death syndrome (SIDS)

Postmenopausal women smokers have lower bone density

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Often not a choice for many, including

children and employees in

smoking facilities

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Surgeon General’s ReportSecond-Hand Smoke

Single greatest avoidable cause of

disease and death

www.who.int/nmh/publications/fact_sheet_tobacco_en.pdf

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Surgeon General’s Report (cont.)

Millions of Americans, children and adults, still exposed to second-hand smoke

Second-hand smoke exposure causes disease and premature death in children and adults who do not smoke

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Surgeon General’s Report (cont.)

Children exposed to secondhand smoke at increased risk for

Sudden infant death syndrome (SIDS)

Acute respiratory infections Ear problems More severe asthma

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Surgeon General’s Report (cont.)

Exposure of adults to secondhand smoke has immediate adverse effects Cardiovascular system and causes Coronary heart diseaseLung cancer

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Surgeon General’s Report (cont.)

The scientific evidence indicates there is no risk-free level of exposure to secondhand smoke

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Surgeon General’s Report (cont.)Eliminating smoking in indoor spaces

fully protects nonsmokers Following actions DO NOT protect

nonsmokersSeparating smokers from nonsmokersCleaning the airVentilating buildings

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Basic Principles of Indoor Air Quality

Apply Basic Principles to ETSSource ControlVentilationAir Cleaning

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Source ControlASHRAE Standard 62.1-2007For air pollution sources other than

people, source control is recommended.ASHRAE uses 15 micrograms/m3 for

PM2.5, if there are NO carcinogensASHRAE’s position is that the only way

to effectively eliminate health risk associated with indoor exposure is to ban smoking activity

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Ventilation for Buildings with SmokingASHRAE Standard 62.1-2007Smoking areas shall have more ventilation

than comparable no-smoking areas.Specific ventilation rate requirements

cannot be determined, because “acceptable risk” has not been determined

Air from smoking areas shall not be re-circulated or transferred to no-smoking areas.100% outside air should be used for ventilation.

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Air CleaningThe use of air cleaners alone cannot ensure adequate air quality, particularly where significant sources are present and ventilation is inadequate.

www.epa.gov/iaq/pubs/residair.html

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Air Cleaning – Don’tsThese methods may make air quality WORSEDO NOT USE Ozone (sold under many different guises)

Ozone is an air pollutantChemical reactions may lead to even more

dangerous air pollutantsAir Fresheners typically attempt to cover up smoke smell and add more air pollutantsDO NOT use electronic or electrostatic cleaners that may add ozonewww.epa.gov/iaq/pubs/

residair.html

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Air CleaningA report from the U.S. Surgeon General

echoes ASHRAE’s position that adverse health effects related to tobacco smoke cannot be eliminated through filtration or ventilation.

True HEPA filter can eliminate some particles from cigarette smoke, but the most hazardous particles are the most likely to get through a HEPA filter.

https://www.ashrae.org/about-ashrae/position-documents

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SummaryThe only way to fully protect non-

smokers is to make the building 100% non-smoking.

If smoking is allowed, aggressive ventilation will reduce the discomfort and health risks for the employees.

Children should never be exposed to cigarette smoke.

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Monitoring Air Quality in Smoking BuildingsASHRAE uses 15 micrograms/m3 for

PM2.5 standard, if there are NO carcinogens

PM2.5 measurements can be taken to identify areas of greatest contaminationReal-time particle countersMini-vol (filter based)Other filter based methods

https://www.ashrae.org/about-ashrae/position-documents

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Instruments

$2K to $10+K

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More Instruments

Recommend that CO2 measurements inside be

about the same as outside.

$450

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Tobacco Resourceswww.cdc.gov/tobacco/www.surgeongeneral.gov/library/

secondhandsmoke/www.cancer.org www.lungusa.org www.nci.nih.gov/ www.ashrae.org/about-ashrae/position-

documents

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Institute for Tribal Environmental Professionals (ITEP)

Mansel A. Nelson, Senior Program CoordinatorIndoor Air Quality in Tribal Communities (IAQTC)Northern Arizona University (NAU)http://www.nau.edu/iaqtc/mansel.nelson@nau.edu

Voice 928 523 1275FAX 928 523 1280PO Box 5768, Flagstaff, AZ 86011

www.nau.edu/iaqtc